Hype Manual Section 3

SECTION THREE: THE HYPE CAREER SERVICE MODEL
HYPE Manual v1 July 2017 Section Three: The HYPE Career Service Model i
HYPE Feasibility Pilot Training
SECTION 3: Notes
THE HYPE CAREER SERVICE MODEL
This section reviews the HYPE model and consists of the following topics:
A. HYPE Model of Career Services
B. HYPE Process
C. HYPE Program Structure
D. HYPE Framework for Services
HYPE MODEL OF CAREER SERVICES

As described earlier, the development of human capital early in life is critical for young
people to access and succeed in the primary labor market, where employment offers
higher pay, greater benefits, greater security during times of extended absences (e.g.,
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family medical leave), and more flexibility than secondary labor market jobs. Employment
programs must modernize their approach to incorporate education into services in order
to prevent issues like unemployment, underemployment, and reliance on government
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entitlements for young adults with mental health conditions. Education should be
considered a vocational intervention required to meet a young adults individualized
long-term career goals. Because there are a number of educational routes one could
take, instead of focusing exclusively on activities related to pursuing post-secondary
education in a traditional college setting, a variety of training and educational activities
(e.g., attaining a GED or high school diploma, attending vocational school, completing
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internships or apprenticeships) are supported. Short-term technical education and/or
training is encouraged for young people who are interested in careers, but do not have the
skills, resources, and/or interest in spending multiple years in a post-secondary educational
setting. Vocational-technical training can include working towards a certificate or license
in a particular field, such as cosmetology, brick masonry, or carpentry, to name a few.
Therefore, practitioners need to be knowledgeable about how to integrate educational
supports into existing programming, as well as how to support students in a variety of post-
secondary educational settings.
Although there is not yet any definitive research suggesting a single best model for
enhancing career development for young people, recognized best practices do exist and
have been incorporated into the comprehensive approach described here. The essence of
the HYPE model emerged from the integration of supported employment and supported
education in community mental health programs in several states, resulting in a cohesive
and comprehensive approach to career services. To develop the HYPE model, this
integrated career services approach was informed and enriched by an extensive review of
the literature, interviews with practitioners of innovative and effective programs, interviews
with young adults with mental health conditions, and consultation with experts, which
includes young people who have used or desire(d) such services. The final result is a refined,
HYPE Manual v1 July 2017 Section Three: The HYPE Career Service Model 3.1
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flexible, and comprehensive model that is specifically designed to meet the needs of young Notes
adults with mental health conditions. The core program elements include those that are
most likely to contribute to successful achievement of the career goals designed by the
young people using these services. Descriptions of the HYPE practice principles, program
process, structure, and critical activities are presented here.
HYPEs Vision:
Young adults with mental health conditions will have access to services and opportunities
that promote professional development and economic independence in order to prevent
disability.
HYPEs Mission:
HYPE assists young adults with mental health conditions to develop the necessary skills and
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support needed to identify, choose, and achieve meaningful careers.
HYPEs Values: the behavioral compass

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1. Flexible: practitioners support is adapted and provided in ways that meet the unique
needs of each young adult in services.
2. Helpful: practitioners anticipate common barriers that disrupt educational and

employment success and work with the young adult proactively to develop skills and
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resources in order to prevent disruption.
3. Solution-focused: practitioners work to creatively resolve practical, every-day issues in

order to maintain positive movement toward the young persons goal.
4. Partnering: practitioners collaborate with each young adult to understand their

circumstances and goals in order to overcome barriers and support sound decision
making.
5. Age-typical: practitioners support the developmentally normative pathways and choices

that are common for most young adults (with and without mental health conditions).
HYPE Principles: the set of directions
1. Career-oriented Services:
HYPE services assist young adults to explore, pursue, and achieve education and
employment goals that will lead to a desired careers and financial self-sufficiency. HYPE
services emphasize education goals that further career development.
2. Cultivation of Identity of Worker & Student: Notes

HYPE services develop resiliency and skills of young adults to create and reinforce the
identity and role of worker and student. HYPE works with family members and mental
health providers to ensure consistent messages and supports are provided in order to
prevent the creation of disability identity.
3. Informed Decision Making:

HYPE services assist young adults in selecting and pursuing vocational goals that are
consistent with their personal preferences, values, and interests by providing factual
information and detailed alternatives to allow them to weigh the long- and short-term
costs, risks, and benefits of potential career pathways.
4. Service eligibility based on choice:

HYPE services accept all young adults who express any level of interest in exploring or
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pursuing education and/or employment. Young people are not excluded on the basis of
diagnoses, symptoms, substance use history, psychiatric hospitalizations, homelessness,
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level of disability, or legal system involvement.
5. Purposeful Service Coordination:

HYPE practitioners work closely with services and supports utilized by the young
adult. Given the various services young adults may be involved with (both within
and outside of community mental health) concerted effort is dedicated to coordinate
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services.
6. Attention to Preferences:
HYPE services are based on the young adults values and choices and assist in
continuous exploration of additional preferences and interests.
7. Personalized Financial Planning:

HYPE services assist young adults in understanding the impact of financial decisions
on long-term self-sufficiency. HYPE services see application to SSA as a last resort and
helps the young person to access other types of financial support. HYPE helps young
adults develop an exit plan if receiving government benefits.
8. Rapid Goal Pursuit:

HYPE services work quickly to help the young adults enter into their desired setting.
Practitioners do not delay pursuit or entrance into either employment or education,
but works intentionally to overcome barriers to entrance as well as develop skills and
resources while concurrently pursuing a young adults goal.
9. Systematic Resource Development:

HYPE services identify and link young people to naturally occurring supports and
services within their communities to support the entrance into and maintenance of Notes
employment and education.
10. Systematic Job Development:

HYPE practitioners systematically visit employers, who are selected based on the
young adults preferences, to learn about their business needs and hiring preferences.
The long- and short-term costs, risks, and benefits of disclosure are discussed prior
to job development. HYPE does not disclose the mental health condition unless it is
preferred by the young adult.
11. Time-Unlimited and Individualized Support:

HYPE supports are individualized and continue for as long as the young adult wants
and needs the support.
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12. Community Integration:
HYPE services connect young people to existing community supports to meet their
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educational and employment needs to enhance community integration. HYPE services
do not duplicate existing supports on campus or in the young adults communities.
HYPE provides additional supports in order for a young adult to access and/or benefit
from the community service/support.
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HYPE PROCESS
This section outlines the HYPE process and is intended to give an overview of how services are conceptualized. The
specifics of HYPE services are detailed in Section 4: Critical Activities of HYPE Services.
HYPE Manual
Table 3.1 HYPE Services Flowchart 7-16-17
Table 3.1 HYPE Services Flowchart 7-16-17
Outreach/Advertising
Engagement
Young Person Expressing Some Level of Interest in School/Work
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Identification of Motivation & Commitment to Goal

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Goal Pursuit Goal Development
Identification of Identification of
Skills, Supports, & Strengths & Barriers
Qualifications to Goal Pursuit
Development of
Primary Primary Intentional Services to
Long-term Long-term remove barriers &
Educational Employment increase commitment
Pursuit Pursuit
Re-evaluation of
factors associated
Goal Redetermination with change
Achievement of Goal
Program Entrance & Intake Notes

Engagement
As described earlier, in order to prevent many of the system effects that older adults with
mental health conditions experience, HYPE services need to advertise, outreach, and
engage young adults early to maintain valued roles and prevent disruptions in school and
work. Service practitioners convey that one of the main barriers to serving young people
is that they are hard to engage. Their lack of engagement in community mental health
services may be for a number of reasons, including their desire to not feel different, their
concern that services do not meet their needs, and service hours do not work with their
schedules (Eisenberg, Golberstein, & Gollust, 2007; Fagan, Munchel, Rogers, & Clark, 2009;
Wang, Lane, Olfson, et al., 2005).
Engagement starts well before intake and includes how programs are initially advertised
and described. During this phase, language and messaging are of the utmost importance
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in relating to young adults and maintaining their interest. HYPE is designed to enhance
engagement early on by focusing service provision on getting to know the young adult and
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the unique factors that brought him or her to services. In order for young people to want
to continue to engage in HYPE services, practitioners need to be genuine, transparent, and
outwardly supportive of young adults in HYPE services.
During the engagement phase, it is encouraged that the amount of paperwork be kept to a
minimum. Completing paperwork is often the focus of initial meetings, but HYPE suggests
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to instead focus on connecting to the young adult in order to establish a relationship and
to understand the purpose for seeking services without completing paperwork. It has been
our experience that copious amounts of paperwork during the initial meeting(s) work
against engagement efforts. Programs should therefore request only the minimum required
information during the first meetings and spend the majority of the time seeking to
understand why the young adult is asking for services.
Practitioner Note: Identify the critical pieces of information needed for documentation
and billing for initial meetings. Early conversations should be focused on what the
young adult would like to accomplish and what his or her successes and limitations
have been when trying to accomplish these or similar goals in the past. Identifying how
HYPE services can enhance the young adults his or her efforts and reduce barriers
will also build intrinsic interest in your program. Personalized conversations up front,
without physical paperwork, may help to build a therapeutic alliance. Time without
paperwork is not wasted time! Information obtained through these conversations can
later be documented and will also be invaluable to service planning later. In addition,
spending the time up front building rapport with the young person is advantageous
to both the agency and the young adult. It increases the young persons engagement in
developing and achieving meaningful career goals as well as increases time the specialist
spends with the young person (i.e. billable services).
Specific engagement recommendations from young adults who helped to create this Notes
manual:
While it may seem difficult, have a greater tolerance for missed or skipped
appointments. This is necessary to maintain meaningful engagement and develop
authentic relationships.
Missed appointments decrease when the young adults needs are being met by services.
Text to confirm appointments and/or meeting location. This is a way to engage youth
in a manner that is appealing (and will also reduce your no-show rate).
Young adults may not respond to your texts, but they get them, so unless they tell
you to stop, continue to text supportive messages and make it easy to come back for
services.
We already feel bad enough, so make it easy for us to come back to services.
Use social media, emailing and other youth-oriented technology to engage young
adults in services.
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Employ staff that are relatable to young adults.
Use typical, non-clinical language, in marketing and advertising materials, as well as in
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appointments, to appeal to young adults.
Practitioner Note: Young adults will be engaged if you listen actively, try to
understand the young adults perspective, and try to be helpful.
Eligibility
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Consistent with the practice principles of supported employment, a young adult with
a mental health condition only has to express interest in or the possibility of pursuing
employment or education to receive HYPE services. Those who express the need for
additional support to maintain their current position as student or employee are also
eligible for services.
As a part of the HYPE approach, ambivalence is considered interest as it provides an

opportunity to influence the trajectory. As described later in this section, it is our belief
that the presence of a HYPE practitioner during times of initial ambivalence can positively
influence and expedite a young adults choice to pursue employment and/or education.
Ideally, young adults who are referred, but state that they are not interested in exploring
or pursuing employment or education, should continue to be seen by HYPE practitioners.
It is just as important to know why a young adult is not interested in school or work as it is
to know why they are interested. Understanding the reasons to not pursue work or school
will help HYPE practitioners clarify barriers and create targeted interventions to develop
interest, motivation, and commitment to regain the valued roles of their age group. If a
HYPE practitioner cannot provide such services due to limitations of funding, training
peer practitioners in HYPE interventions could serve this same purpose: to create interest,
motivation, and commitment. By intentionally moving people through the stages of
change and cultivating an interest, a young adult can return to HYPE services more quickly
and reduce the length of disruption in work and school. If an organization does not have Notes
the capacity to provide HYPE services during this time and does not have peer support to
bridge the gap, then a HYPE practitioner should reach out to the young adult in one to two
months to check in and maintain a relationship. It should be noted that organizations that
fall into this last category should explore additional funding streams to be able to support
engagement, relationship development, and influence the factors associated with change.
HYPE and/or its parent organization should intentionally target young adults who have not
expressed interest in pursuing employment or education. Although outside of the scope of
this manual, it should be noted that in the absence of purposeful cultivation of identities
related to student and employee, young people are at risk of assuming an illness or disability
identity and may later become reliant on mental health services and federal benefits. It
is developmentally normative to pursue work and school during young adulthood and
mental health services should focus on and coordinate all services around the pursuit and
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acquisition of these valued roles in order to prevent long-term disability.
Practitioner Note: HYPE services should maintain contact with young adults
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who are not interested in receiving services, but have been referred. On-going
and assertive outreach not only shows support and interest on the part of the
practitioner, but may also develop hope and optimism in the young adult that
employment and education is possible and beneficial. It is our belief that this
combination of factors may increase the likelihood that young adults will return to
services later.
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At this point, services have been designed solely for people with mental health conditions.
The HYPE model has not been modified, piloted, or tested with young adults with Autism
Spectrum Disorder (ASD) or those previously diagnosed with Aspergers Syndrome. To
successfully navigate school and work, those with intellectual or developmental disabilities
may benefit from additional strategies and supports that have not be considered for this
manual.
Intake & Assessment

Similar to high quality Supported Employment (SE) services, assessment is an on-going
process in HYPE through formal and informal means. The HYPE practitioner focuses
on developing a positive therapeutic alliance as the basis of services and works to better
understand the life factors that have influenced the young adults previous employment
and educational pursuits. During the engagement, intake, and assessment phases of
services, the HYPE practitioner and young adult actively work together to (1) to identify
a goal and/or (2) pursue a goal. HYPE services are focused on expediting entry into
chosen environments without delaying pursuits due to lengthy assessment periods or pre-
placement training.
HYPE practitioners are purposeful in their evaluations and conduct a comprehensive intake that focuses on the
strengths and barriers to the pursuit of the young adults career goal. Factors such as motivation, confidence,
commitment, resources, support, and self-efficacy, all of which influence both success and failure, are evaluated
early on in services to assist the practitioner in developing intentional, targeted interventions to reduce barriers
and enhance areas that may be potentially limiting. Assessing these factors associated with change is typically not
conducted within SE programs but is a foundational element of HYPE. An overview of the process is emphasized
within
Figure 3.2 this manual and the Factors Associated with Change Assessment (AFAC; Farkas et al. 2000), as well as other
HYPEintake
Service Pathway
and assessment documents, can be found in the Addendum.
Figure 3.2
HYPE Service Pathway
Primarily SEd Education Path:

may include short-term work*
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Career Staff are
Moderate to High Exploration
Factors Levels of crossed-trained
Associated & in companion
with Change Motivation &
Commitment
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Determination
path
Primarily SE
Employment Path:
may include short-term school*
Low Levels of
Motivation &
Commitment
Intentional Development of
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Motivation & Commitment
Goal Development
Commitment to Vocational Goal: Tailoring Services based on Needs

The foundation of HYPE services is comprised of the Transtheoretical Model (TTM; Stages of Change), Motivational
Interviewing (MI), and Boston Universitys model of Choose-Get-Keep-Leave. For practitioners who are not familiar
with TTM or MI, it is strongly encouraged to seek additional training and supervision, as this manual relies on
knowledge of TTM and MI. As described later in more detail, the HYPE model uses these modes/approaches to
guide the timing and types of interventions and supports delivered (Prochaska & DiClemente, 1983; See Appendix for
Educational Intervention Matrix).
HYPE service can be loosely categorized into two branches of services: goal development and goal pursuit. In goal
development, the young adult is unsure of the goal, but interested in participating in services. Young adults in this
service branch are typically in the contemplation phase and some may be early in the preparation phase with moderate
levels of ambivalence. In goal pursuit, the young adult is actively pursuing a defined goal in employment and/or
education. Individuals in this service branch are typically in the preparation and action phases.
The general activities and supports associated with goal development are well defined Notes
within SE practices (e.g., identification of strengths, barriers, clarification of interests
and preferences) and culminate in a service plan that intends to remove barriers and
increase commitment to goal development. Goal development is not a protracted amount
of time, but rather services are intentionally crafted to reduce the number of real or
perceived barriers to pursuing employment or education and to enhance the young adults
commitment and motivation. If a young adult does not have an expressed goal when
beginning HYPE services, the practitioner works quickly and intentionally to develop
interests and expose him or her to experiences that could promote the identification of a
goal. The HYPE practitioner will work with other care practitioners and family members
(either biological or chosen) during the engagement and goal development phases.
Practitioner Note: It is important to keep in mind that those who are ambivalent
toward developing employment or educational goals need specific types of inter-
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ventions to benefit from services. Drawing on TTM and MI, a less action orient-
ed approach, to cultivate commitment and motivation will enhance engagement
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and will ultimately reduce the amount of time to develop real, meaningful goals
and a targeted service plan.
Goal Pursuit
Similar with goal development, goal pursuit activities are well defined within SE practices.
The main difference with HYPE services is that young adults create career goals, where
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the identification of the career pathway is required. The HYPE practitioner completes a
comprehensive review of the skills, supports, and qualifications with the young adult to
assess if additional experiences, including academic pursuits, are required to achieve the
desired goal. These activities help young people identify whether their goal is primarily
long-term education or rapid employment pursuit. The result will almost always be some
combination of work and school as a long-term plan, but the immediate goal will be highly
dependent on the young adults immediate interests, resources, and supports.
There are two primary pathways to achieve a career goal: (1) long-term formalized education
that results in the academic qualifications for the position and (2) rapid attachment to
the chosen workforce, where short-term education/training is needed for the practical
qualifications for the position. For example, if the career area is nursing, one young adult
may be interested in pursuing a bachelors of science in nursing (BSN), which would be the
primary pathway of education, while another may be interested getting a job as a certified
nurses assistant (CNA), which would require a short-term training program and would be the
primary pathway of employment. After the young adult and practitioner identify the primary
pathway, a goal plan is developed in coordination with other care practitioners, family
members (either biological or chosen), and any other person of the young adults choosing.
HYPE services are designed to anticipate and support young adults as they develop their
vocational maturity and it is therefore expected that some will change their goals as Notes
they understand more about themselves as a worker, student, and within their selected
occupation. HYPE practitioners explore the need for change with the young adult, help
make informed decisions, align critical resources, and minimize vocational disruptions
during these times. HYPE services are designed to be flexible to support young adults over
time and between pathways.
Cyclical Nature of Goals

Of course, developing, setting, modifying, and achieving goals is a normative process.
As one goal is close to being achieved, often others are being developed and refined. This
cyclical process is particularly true for young adults in HYPE services, as they are early in
their vocational maturity and occupational development. It should be expected that young
adults who select a primary employment pathway will, over time, identify an educational
goal or training need to enhance their job status. As this young adult nears completion
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of his or her educational goal, an employment goal that is better aligned with the chosen
profession is being developed. af
Practitioner Note: It is our belief that if HYPE practitioners teach skills in all
phases of services (goal development through acquisition), young adults will not
need intensive on-going services over time. In our experience, young adults may
seek out consultation for decision-making, assistance with finding resources, or
navigating systems, but often will not require intensive on-going services.
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HYPE PROGRAM STRUCTURE
In this section, the programmatic structure of the HYPE model is described, including
considerations for staffing roles, programming structure, hours, and policies.
Staffing
In the HYPE model, it is preferable to have specific practitioners who specialize in

supporting educational pursuits and others who specialize in supporting employment
endeavors. Staff are cross-trained in the complementary pathway, resulting in career
service staff with primary areas of concentration. The purpose behind training staff to be
specialists in one primary service with general knowledge of the other is to minimize the
disruption a young adult would experience if they concurrently pursue employment and
education.
Cross-training practitioners provides the flexibility to serve a young adult who requires
short periods of support in the complementary pursuit (work or school) without the
disruption of changing practitioners. For instance, the young adult who chooses to
become a CNA has the primary pathway of employment, but will be required to attend
a short-term vocational preparation (typically between 4-6 weeks of training) to be
eligible to sit for the certification. There are some employers who offer the training as Notes
a part of employment, but many require an outside institution to provide the training.
Instead of transitioning this young adult between two practitioners who specialize in
specific pathways, one practitioner would be able to help the young adult through all of
the necessary job acquisition activities, which in this instance would include vocational
training. Similarly, for the young adult who chooses the BSN route, a practitioner would be
specialized in providing educational supports, but adept enough in employment services
to assist in helping to develop and support summer work opportunities. A core feature
of HYPE services is that practitioners will utilize the experiences and networks of their
colleagues in order to provide high quality services. For instance, educational specialists
will seek out and rely upon on their employment counterparts expertise, as well as their
employment-related networks, regarding employment-specific practices or when helping
to connect a student to an internship or employment opportunity.
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Some programs do not have enough staffing, funding, or number of people being served
to be able to support specialized staffing in both employment and education. However,
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the HYPE models integrated approach of the skills, knowledge, and abilities of specialized
practitioners in this model is necessary to fully engage and support youth and young
adults, and to produce good outcomes. As described above, there are unique areas of
knowledge and competencies that are required to successfully assist a young adult with a
psychiatric condition in navigating a college campus; just as job development and coaching
are highly refined skills sets that require many years to develop real expertise.
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Staffing Criteria
HYPE practitioners, either Employment or Education Specialists, should not serve more
than 25 young adults. During the first year of implementation, the number of young adults
served should be reduced to allow staff to learn their roles, which includes getting to
know their local training and post-secondary educational institutions and the community
resources that can support educational attempts.
Roles
Director
The Director ensures that the Team Leader has the resources and supports to operate
the HYPE team. The Director should work with the leadership of the organization to
develop coordination with other important supports and resources, including diverse
reimbursement streams that can support a variety of services that may be outside of the
scope of the existing SE contract/ reimbursement mechanism. The Director works with
other agency directors, both within and across agencies and systems, to strategically market
HYPE services to collaborating providers, develop information sharing agreements, and
coordinate standing meetings of relevant teams to ensure coordination and integration
where possible. Supervision should be provided regularly with the Team Leader to oversee
service outcomes, quality of services, units of service, adequacy of resources, advertising Notes
to young adults and collaborating providers, and feedback from relevant stakeholders. The
Director should serve as the Team Leaders back up for engagement activities, intakes, and
other duties during periods of short-staffing or high demand.
Team Leader
It is suggested that HYPE teams have a Team Leader. The Team Leader runs the weekly
team meeting, provides individual supervision, oversees the services, and ensures adequate
staffing. Moreover, the Team Leader should take the lead in cultivating a cohesive team and
work culture that is aligned with HYPEs mission, values, and principles. Over time, if the
number of young adults in services grows, a Senior Counselor or Assistant Team Leader
may be needed to provide adequate mentorship and supervision and ensure that other
administrative functions are being met. The Team Leader should have a masters degree in
a field that is complementary to the work, such as rehabilitation counseling, social work,
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counseling, or human services.
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It is suggested that the Team Leader not be assigned a number of people to work with, but
rather is a part of the engagement process and meets individually with all young adults as
they enter into services. In these initial meetings, the Team Leader gets to know the young
adults, begins to assess the factors associated with change, and matches the young adults
with a HYPE practitioner, taking into consideration factors such as primary pathway,
personality, and unique challenges. In addition, during these initial meetings, the Team
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Leader should begin the process of fostering hope within the young adult, as this sets the
tone and encourage or deter engagement in services. The young adult knows from the
first meeting that the Team Leader will not be a practitioner of services and is told that
the Team Leader is the person who is responsible for ensuring high quality services are
provided.
Specialists
Similar to the Individual Placement and Support (IPS) model, it is suggested that those
who provide services to young adults are referred to as specialists (i.e., Employment
Specialist and Education Specialist). It is suggested that Education Specialists have
experience in supporting educational goals of individuals with mental health conditions.
Qualifications
The level of the HYPE practitioners level of formalized education influences the quality
of their work and outcomes associated with the programs. Practitioners with a bachelors
or masters degree often do well in these positions given their own experiences with,
commitment to, and value associated with their higher education. It has been our
experience that those without a higher education have increased levels of difficulty being
effective as an Education Specialist. The role of student and the postsecondary educational
environments are very complex and the absence of personal experience, interest, and/or
success in the higher education makes it more difficult to anticipate and respond to student Notes
issues. Practitioners who are also students report being able to better relate to the struggles
of those they are helping and often find themselves sharing personal strategies and working
in partnership to develop strategies. The lack of higher education and personal experience
has been a major limitation in hiring a skilled peer workforce in some regions.
Finding qualified staff is often difficult because there are very few opportunities for
practitioners to develop the required skill set outside of supported education (SEd)
programs and there are very few SEd programs in the US. SE staff, as well as staff from
university/college Disability Services Offices, are well suited to transition to the role
of Education Specialist. Arguably, nearly all skills are teachable and, in the absence of
experience, education and prior work experiences that emphasize skill development and
community-based work is important. Finally, when hiring, programs should carefully vet
applicants to ensure value alignment. When practitioners do not know what or how to do
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something, they rely on their own personal values to guide their work. It is important to
ensure that their values are consistent with the values and desired outcomes of HYPE.
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Teams
Given the design of the program, it is suggested that Employment and Education
Specialists work as a team to enhance services and minimize unnecessary transitions
between counselors. The Team Leader assigns young adults to a primary Specialist who will
work with them through their time in services. During the engagement phase, those with
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a primary educational pathway are connected to an Education Specialist and those with a
primary employment pathway are connected to an Employment Specialist. For the young
adults who are unclear or ambivalent about a primary pathway and the probable route is
uncertain, the Team Leader must do their best to assign the young adult to a practitioner
who can engage and best facilitate the development and articulation of the young adults
goal. Staff work together to identify services, supports, and resources that will assist in
the development or pursuit of the young adults goal. The team will also work together to
identify another practitioner to work with the young adult during times of vacation, sick
time, or anticipated staff vacancies.
Program Note: Some SE programs that have integrated educational supports

have used a secondary practitioner approach. Young adults are introduced to
the secondary practitioner early on as a way of providing an additional level of
support during times where their primary practitioner may out of the office or
unavailable. This approach has been particularly helpful to services that have a
large geographic area and varying hours (evening or weekend hours) to ensure
coverage is always available.
Supervision Notes
It is suggested that teams meet together once a week to discuss the young adults they
are serving. Weekly team meetings are a helpful mechanism of supervision and can
serve as professional development to expand practitioner skill and knowledge. These
team meetings enhance services by facilitating an exchange of ideas across staff through
discussions about the young adults they are serving in order to problem solve and celebrate
successes. Sharing strategies and interventions develops the knowledge of all participants
and should be a mandatory element of service. These meetings are critical during the first
year of service and may be lengthy, but as teams become more skilled, these meetings will
become more efficient. Utilizing a structured meeting agenda and/or a team supervision
form will assist in reducing the overall meeting time, provide consistency and structure
to the discussions, and ensure that all pertinent topics are addressed (See Appendix for
supervision worksheets and template). Team meeting notes should also be documented
and stored, so that the team may refer back to them as needed or to review follow up items.
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In addition to weekly team meetings, each Specialist should receive one-to-one supervision
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according to their programs licensing or regulations of the staff s credentials. Supervisors
should shadow their staff during meetings in the community (also referred to as in-
vivo supervision or ride-along) to observe the practitioners interactions with the young
adults they are serving. This can be an interactive process (and not just an observation),
as the young adult should feel supported by both supervisor and practitioner. If there
are no licensing regulations for either the staff or the program, the Team Leader, along
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with leadership of the agency, should develop criteria to ensure high quality services. It is
HYPEs recommendation that individualized supervision should occur weekly, with the
understanding that, due to staffing issues or vacations, bi-weekly supervision will suffice for
short periods of time. Supervision should be documented; concurrent documentation is
also helpful for supervisors and practitioners to agree and become aligned on the outcome
of supervision (See Appendix for supervision worksheets and template).
Goal plans are excellent tools to use in individual and group supervision. They articulate
the map of services and are helpful to use as the platform to discuss progress, barriers
(experienced by both the practitioner and young adult), and next steps. Identifying two to
three goal plans to review per week is especially helpful to develop practitioner skill, assess
quality of progress notes, revise plans that are not working, and familiarize supervisors
with the young adults being served. The Comprehensive Profile worksheet can also be
used in supervision to assist in service planning (See Appendix for Comprehensive Profile
worksheet).
Program Elements
Program Structure
HYPE services have been structured differently than the traditional IPS program in that
the initial phase of service, engagement, is based on a consultation approach. Services Notes
are designed to be conversational and informational gathering with a reduced focus on
paperwork. The purpose of this design was to put the persons needs before the needs
of the service (e.g., paperwork), but it is recognized that programs may need to modify
contracts or develop additional funding mechanisms to cover the staff time associated with
engagement. Programs that have successfully developed funding allow for up to 10 hours
of work prior to initiating the intake process.
Program Funding
Career services is at an exciting point in its development and is becoming more recognized
by county, state, and federal funding mechanisms as a critical service to prevent disability
and enhance recovery for adults of all ages. For example, the increased attention on
first episode psychosis and the corresponding federal block grants from SAMHSA has
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incentivized states to develop programming to help young adults who are at risk for
or struggling with psychosis. These programs have career services integrated within
programming. With these exciting developments, the importance of integrating and
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funding education within employment services has been highlighted.
Programs that have successfully integrated employment and education have developed
braided funding. The typical funding mechanisms are:
State and County Division of Mental Health Services (i.e., fee for service or contracts)
Vocational Rehabilitation (Rehabilitation Services Administration)
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Federal Block Grants
Medicaid
Hours
HYPE services have flexible hours (including early morning, evenings, and weekends) to
meet the needs of the young adults in services. Given the varied nature of employment
and education, HYPE teams should work together to develop program hours that meet the
needs of the young adults and the program; for instance, all practitioners should be in the
office at least once a week for team meetings. Practitioners should work with their Team
Leaders to develop flexible schedules to meet young adults during their preferred times in
their communities. It should be the expectation that these schedules may change based on
the semester and/or jobs.
Technology
Technology should be used to enhance services for young adults. It can help to strengthen
a therapeutic alliance (e.g., sending an encouraging text before a test) or to help young
adults develop important skills (e.g., using the share screen function of a web-conferencing
platform to work on calendaring skills). Depending on the needs of the young adult and
the requirements of the job or course, web-based technology can help connect practitioners Notes
and young adults in meaningful ways. Technology can also be incredibly helpful during
times of high student demands (e.g. finals), when finding time for an in-person meeting
may be difficult.
Policies
Many policies may need to change as programs integrate educational supports and serve
more young people. Policies should be evaluated to ensure they are consistent with HYPE
principles and should be crafted so young adults can access services to receive critical,
time-sensitive support. Not all young adults will need on-going services and HYPE should
be responsive to these types of demands. HYPE services are intended to develop skills,
abilities, and competencies so that young adults do not become overly reliant or dependent
on mental health services for their livelihood. It is therefore expected that as skills and
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competencies develop, young adults will need less support over time and will transition to
using HYPE services only when needed, just like any other critical support.
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Special consideration should also be directed toward discharge policies. For young adults
who struggle with engagement, policies should support a seamless return to services. It is
strongly suggested that young adults should not be discharged from services due to a series
of no-shows. As described earlier, young adults may at times struggle with engagement.
It is the role of the program to evaluate the reasons for lack of engagement, including
no-shows, and try to re-engage a young adult who could benefit from HYPE. Common
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reasons for lack of engagement and no-shows are (1) the young adults perceived services
as not able to meet their needs, (2) there are practitioner-based issues that isolate young
adults (e.g. lack of expertise, numerous cancellations, lack of preparedness), and (3) and
the young adult is not interested in services. Given the multitude of reasons for lack of
engagement, many programs use an inactive status to allow time to help re-engage the
young adult to come back into services without going through the intake process. Inactive
status also allows students who do not need on-going intensive services to access help
when they have a critical need or when they need to come back to services for regular
assistance.
HYPE FRAMEWORK FOR SERVICES

HYPE was designed by integrating many models, approaches, and techniques as a way
to meet the needs of young adults with mental health conditions and structure services
to be highly effective. HYPE integrates education into supported employment (e.g., IPS)
by layering C-G-K-L, TTM, and MI and is the framework for services. The integration of
C-G-K-L, TTM, and MI provides scaffolding for services and meaningful guidance for
practitioners to select interventions, including how they respond, that purposefully move
young adults through the stages of change to accomplish real-life goals.
This section reviews the C-G-K-L model, the TTM, and MI. IPS will not be reviewed as a Notes
separate model given the nature of this manual, but examples of employment supports will
be illustrated within this section, as many SE programs do not use the C-G-K-L approach
to services. It is our belief that by highlighting employment supports and interventions, SE
practitioners will better be able to visualize how C-G-K-L is a natural fit to programming
despite the potential lack of familiarity.
Choose Get Keep Leave Model

C-G-K-L was developed at Boston University in the early 1980s and was first used in SE
(Anthony, Howell, & Danley, 1984; Danley, Sciarappa, & MacDonald-Wilson, 1987). C-G-
K-L is a highly structured, but flexible approach to helping someone identify and pursue a
personally meaningful goal. This goal setting process is based on the normative approach
to goal development and acquisition. Individuals may not be aware of this process when
setting or working toward a goal, but the C-G-K-L model is a thorough and deliberate
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approach to setting goals that drive services. HYPE services uses the C-G-K-L approach
as a way to focus services on the activities designed to move young adults through the
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goal development, pursuit, and acquisition process. Operation manuals for SE (Danley &
MacDonald-Wilson, 1996; Center for Psychiatric Rehabilitation, 2002) and SEd (Sullivan-
Soydan & Legere, 2005; SAMHSA, 2011) describe the C-G-K-L processes in detail. The
program model is based on empirical studies, in which practitioners used elements of
psychiatric rehabilitation technology in vocational interventions (e.g., Brown, Ridgway,
Anthony, & Rogers, 1991; Jacobs, 1998, Rogers, Sciarappa, MacDonald-Wilson, & Danley,
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1995; Shern et al., 1997; Unger et al., 1991).
C-G-K-L is focused on choice and informed decision-making. Through exploration and

gaining experiences, a young adult chooses whichever role or environment they want to
pursue first, and services are provided so he or she can acquire the desired role, maintain it,
and eventually leave it (if necessary).
Choose activities are designed to help the young adult explore interests and abilities
related to work and school. The practitioner assists the young adult to discover and
assess his or her aptitudes and skills and identify the things he or she likes and dislikes
using current and past experiences. The young adult begins to research majors and
evaluate schools or potential job possibilities and then formulates a goal.
Get activities assist the young adult to acquire the desired role using a range of tasks,
such as assisting with mock job interviews, requesting transcripts, writing a personal
statement for a college application, providing support during phone interviews, and
scheduling study time for the SATs.
Keep activities use resources and supports to assist the young adult with maintaining
the desired role, such as helping to secure reasonable accommodations, identifying
work-ready clothes, developing strategies to improve memory, and making friends in Notes
new situations. The keep phase is focused on preventing disruptions by recognizing
signs early and troubleshooting barriers as they arise throughout the process.
Leave manages how a young adult ends engagement in a role, leaves a setting
constructively, and prepares for the transition. Leave activities can be for a variety
of reasons, such as a change of goal, need for enhanced self-care, and success in the
current role and environment. Therefore, activities can range from taking a medical
leave of absence to graduation from college or a career move to another company.
The C-G-K-L works to provide people with an opportunity to choose where they want
to learn or work, get into a desired job or educational program, and then to develop the
skills and supports they need to be successful and satisfied as a worker or student. Since it
is unlikely that a young adult will be in the desired job or school for life, the practitioner
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supports the person in deciding when and how to leave school or work.
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The C-G-K-L typically is a sequential process, but the sequence can vary. It is not a train-
place model in which each step must be accomplished before proceeding to the next.
A young adult might enroll in school and, once a student, be in an excellent position to
explore and choose another major or even transfer programs or schools. Similarly, it often
easier to get a new job while already employed, so phases may occur simultaneously. For
young adults in school, C-G-K-L is used each semester to select courses, course load,
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timing of courses, strategies to get the desired classes, skills and supports required to pass
each of the courses, and, if necessary, when to add/drop/replace/withdraw a class(es).
Throughout the process, practitioners use effective interpersonal skills such as listening,
demonstrating understanding, and coaching/inspiring to connect and develop a
relationship with the young adult.
Transtheoretical Model (Stages of Change)

The Transtheoretical Model (TTM) is one of the most promising models for understanding
the process of change. It was developed by psychologist James Prochaska and his associates
at the University of Rhode Island. Prochaska and his associates (1992, 1994) studied people
trying to make a number of changesquitting smoking, increasing exercise, changing their
diets, and reducing or eliminating their use of alcohol. The more people they studied, the
more they began to notice patterns in the process of change. Those patterns suggested a
cycle or a set of stages that people go through when trying to make a change. The research
suggested five stages or phases of change:
Pre-contemplation: Has not yet considered change (e.g., pursuing employment or

education)
Contemplation: Considering change (e.g., exploring the possibility of going to school Notes
or work)
Preparation: Initiates the change process by initial steps of goal development (e.g.,
beginning the application process or revising a resume)
Action: Actively engaged and committed to goal pursuit (e.g., enrolling in school,
accepting a job)
Maintenance: Actively works to sustain changes by developing beneficial behaviors into

habits and enhance skills to support gains (e.g.,) reviewing and rewriting notes within
24 hours of class or sending end of the day summary to their boss outlining the days
activities)
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These are not 1-2-3 steps that everyone goes through in order, but more like a general
pattern for understanding the change process. Recent versions of this stage model include
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a stage of relapse. This stage was added since many people find that they slip at some
point or another. It is important to recognize that a lapse is not necessarily a relapse
(Prochaska, Norcross, & DiClemente, 1994). One slip does not mean that the change
process has come to a halt or that the intervention is a failure. Stressing the likelihood
of slipping changes the image of failure into an image of a new opportunity to learn
about what is needed to maintain a behavior change. An experience that someone labels
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as a failure tends to rob that person of the energy needed to go on, whereas building in
the expectation that everyone slides backwards once in a while creates the possibility of
viewing that failure as just another element of goal pursuit, rather than the end of the
goal.
Motivational Interviewing
As described in more detail later in Section 4, Motivational Interviewing (MI; Miller &
Rollnick, 2013) is an approach designed to help move people from pre-contemplation
or contemplation towards preparation and action. Too often, service practitioners offer
action-oriented solutions to people who are not yet at the action stage, with poor (or even
disastrous) results. In MI (Miller & Rollnick, 2013), the factors associated with change are:
Desire: I want to
Ability: I think I can
Reasons: If I did X, I would benefit because
Need: Doing X is important because
Commitment: I will
These factors are summarized as DARN-C and represent the type of change talk that
you want to listen for and encourage. Overlapping these factors are the three broadest
categories of factors associated with change: motivation, commitment, and awareness. The Notes
integration of C-G-K-L, TTM, and MI are the framework of services that allows HYPE
services to be intentional and strategic, while also being responsive to young adults needs
and goals in order to support long-term, sustained change.
As described by Miller and Rollnick (2013), people are often ambivalent about change,
alternating between wanting to stay and gothat is to continue on the same way or
to make some specific change. Ambivalence is when someone sees both the advantages
and disadvantages of changing. When a persons statements are in favor of staying as
is (instead of changing), that is known as sustain talkthe stay side of ambivalence.
If another person argues for change (such as by giving advice), the natural reaction
is to respond by arguing against change (sustain talk). Change talk, which you want
to encourage, highlights the go side of ambivalence. Advice and information can be
helpful when someone asks for it. Dont just unload information on someone, but work
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to understand their perspective and needs carefully and help them reach their own
conclusion about any information you provide.
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Practitioners commonly find it challenging to work with young adults at the stages of pre-
contemplation and contemplation, often because practitioners are not trained on how to
help move through these phases, but rather, are trained on assisting those in action. The
preparation and action stages tend to be easiest, because practitioners want to see someone
taking steps (or at least making a plan to take steps). Many young adults can be in the pre-
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contemplation stage, related to going to school and work, for long periods of time because
of multiple factors, including the conflicting messages they commonly hear from other
practitioners and potentially family members regarding the stress of school and/or work
or the impact on current or potential SSA receipt. For practitioners who are not skilled in
developing discrepancy as a strategy to move to more action-oriented stages, the result is to
force change. Practitioners commonly think success as a service practitioner depends on
the speed of goal acquisition. This pressure can cause practitioners to act in ways that make
change less likely, such as arranging for job interviews when a young adult is exploring the
idea of returning to work.
Practitioner Note: Use the supports of your team, supervisors, and other skilled
practitioners to manage your feelings of pressure. Practitioners may need to
learn new ways of documenting interventions so they meet regulations and are
billable time. Its OK to ask for that help.
The stage of contemplation creates its own pressures. It may be hard for a practitioner to
listen to people debate both sides of their ambivalencebut that is exactly what is most
helpful. Listen for change talk and reflect what you hear. Use open-ended questions to draw
it out. Be patient, understanding, and supportive. Change will come and it will be sustained
change. Targeting interventions that focus on this phase will help to speed up the real Notes
change process.
It is important for a practitioner to understand the young adults point of view. What
is important to him or her? What is he or she motivated to do now? What is he or she
motivated to avoid? What are his or her strengths, interests, preferences, goals, hopes, and
dreams? What positives can be affirmed? Practitioners should focus on reflecting and not
confronting. Perhaps a practitioner is working with a student who is struggling with her
grades and she mentions her GPA to you. You might reflect that it seems like her grades
are important to her. Affirmations help because it is when people experience acceptance
of themselves as they are that change becomes possible (Miller & Rollnick, 2013, p.
[Chapter 18 on Developing Discrepancies, pp 243-254]). When your attitude is positive,
encouraging, and supporting, a practitioner creates an atmosphere of safety that makes
it easier for a young adult to consider the possibility that life could be a little better or that
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different decisions can be made and change might be both desirable and possible. Perhaps
the same student mentions that her GPA could be higher and she is thinking she could
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change her study habits a bit but is distracted by friends. A practitioner might start with,
You really value your friends and want to spend time with them. Even if a practitioner is
not quite right or off in their response, reflecting allows the young adult to clarify. When a
young adult provides clarification, it not only makes it clearer for the practitioner, but also
for them.
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Once a practitioner knows the young adult well and can view the person in a positive and
understanding way, the practitioner can begin to look for discrepancies. A discrepancy
is a difference between how the person is or lives now and how the person wants to be
or live. Recognizing this difference is one of the most fundamental drivers of change.
To continue with the previous example with the student, a practitioner might say, You
mentioned that your GPA was on your mind and that you want to study a little bit more
but you also like to make time for your friends during the week.
A practitioner can help develop discrepancy by asking what a person already knows
about an area where they may have concerns. A practitioner could also provide
information, as long as its new (otherwise its just repeating what they already know)
and the young adult is willing to consider it. Depending on the environment, sharing
information by making it available (not necessarily offering it), such as leaving a brochure
where someone might see it, may also be helpful.
As always in MI, the vital foundation for providing information is the underlying
spirit of partnership, acceptance, and compassion. Emphasizing personal choice
helps here (Its really up to you; Youre the only one who can decide this.)
and it is done without even a hint of irony or sarcasm, because its the truth. (Miller
& Rollnick, 2013, p. 249)
Notes
You also can use feedback, beginning with, How do you think youre doing with ?
Then, after reflecting on what the person says, you might add an observationsomething
very short and very obvious that you notice. Remember, in order to be motivating,
a discrepancy has to be large enough to encourage change but not so large as to be
demoralizing (Miller & Rollnick, 2013, p. 254).
A person in the preparation stage has made a commitment and is developing a plan.
Its tempting to jump ahead, but the desire to shortcut preparation and leap into action
prematurely is [a] common problem. Being so close to action makes people antsy, but
premature action usually leads to ineffectual change (Prochaska at al., 1994, pp. 147-
148). A student may want to investigate full time options for school after having been out
of academia for a long while because the financial aid is easier to acquire. A worker may
want to research a career rung that is too challenging for a potential next step. Gathering
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information, setting goals, detailing small action steps with clear timelines, and anticipating
barriers can be useful ways to help someone in the preparation stage. A method for
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monitoring progress and actions taken also can help. The service practitioner also needs to
explore the dos and donts of helping by asking, What can I do to be helpful? and What
should I avoid doing? (Prochaska et al., 1994; Swarbrick, 2013). Brainstorming ideas for
developing factors associated with change for a particular young adult can very helpful.
It works especially well in a team as other HYPE practitioners would also benefit from a
shared discussion of assessing and developing factors associated with change.
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SECTION THREE: THE HYPE CAREER SERVICE MODEL

HYPE MODEL OF CAREER SERVICES

HYPEs Values: the behavioral compass

2. Helpful: practitioners anticipate common barriers that disrupt educational and

3. Solution-focused: practitioners work to creatively resolve practical, every-day issues in

4. Partnering: practitioners collaborate with each young adult to understand their

5. Age-typical: practitioners support the developmentally normative pathways and choices

HYPE Principles: the set of directions

2. Cultivation of Identity of Worker & Student: Notes

3. Informed Decision Making:

4. Service eligibility based on choice:

5. Purposeful Service Coordination:

7. Personalized Financial Planning:

8. Rapid Goal Pursuit:

9. Systematic Resource Development:

10. Systematic Job Development:

11. Time-Unlimited and Individualized Support:

Young Person Expressing Some Level of Interest in School/Work

Identification of Motivation & Commitment to Goal

Program Entrance & Intake Notes

As a part of the HYPE approach, ambivalence is considered interest as it provides an

Intake & Assessment

Primarily SEd Education Path:

Commitment to Vocational Goal: Tailoring Services based on Needs

Cyclical Nature of Goals

In the HYPE model, it is preferable to have specific practitioners who specialize in

Program Note: Some SE programs that have integrated educational supports

HYPE FRAMEWORK FOR SERVICES

Choose Get Keep Leave Model

C-G-K-L is focused on choice and informed decision-making. Through exploration and

Transtheoretical Model (Stages of Change)

Pre-contemplation: Has not yet considered change (e.g., pursuing employment or

Maintenance: Actively works to sustain changes by developing beneficial behaviors into

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